High-dose tamoxifen reverses drug resistance to cisplatin and etoposide in a patient with advanced large cell carcinoma of lung.

A 64-year-old man was diagnosed as having large cell carcinoma of lung and suffered from recurrent tumors after repeated surgical resection and local irradiation. Systemic chemotherapy with chronic oral etoposide, and then 5 courses of intravenous cisplatin and etoposide (PE) resulted in disease progression with multiple new lung nodules and a severe superior vena cava syndrome. Empirical treatment with a PET regimen, which incorporated high-dose tamoxifen (TAM) 150 mg/m2/day into original PE regimen, was tried. Nearly total tumor necrosis was achieved after 5 courses of PET with remission duration of 4.5 months. The excellent response by simple addition of TAM into a previously inactive PE regimen advocates further investigation.